Family History Of Atopic Disease Research Articles

Self-report prevalence and associated factors to drug hypersensitivity in Mexican young adults.

BackgroundDrug hypersensitivity is defined as any unfavorable reaction that occurs after the administration of any drug. It may or may not be mediated by the involvement of the immune system. Epidemiological data related to drug hypersensitivity reactions in our country are scarce.ObjectiveTo determine the prevalence of drug hypersensitivity in a group of young adults, as well as to identify associated factors.MethodsA structured questionnaire was applied to young people aged 18 to 25 years. The instrument was oriented to identify reactions of drug hypersensitivity, as well as the most prevalent drugs involved. In addition, a personal and family history of atopic diseases was included. Analysis for associations between variables was been done through logistic regression.ResultsThe prevalence of drug hypersensitivity reactions was 12% (144 of 1,200). The antibiotics were the agents most related to hypersensitivity reactions (9.8%) followed by nonsteroidal anti-inflammatory drugs (1.6%). Factors associated with drug hypersensitivity were a personal history of asthma, odds ratio (OR) 3.15 (95% confidence interval [CI], 1.44–6.91), maternal and paternal history of drug hypersensitivity, OR 2.33 (95% CI, 1.21–4.48) and OR 3.11 (95% CI, 1.22–7.92), respectively.ConclusionThe results of this research show that drug hypersensitivity in young adults is a highly prevalent event and it is associated with personal history of asthma and history of drug hypersensitivity in parents.

Early childhood risk factors for rhinoconjunctivitis in adolescence: a prospective birth cohort study

BackgroundRhinoconjunctivitis is a global health problem and one of the most common chronic conditions in children. Development of rhinoconjunctivitis depends on both genetic and environmental factors. Many studies have investigated rhinoconjunctivitis, but only few studies have evaluated the risk factors for non-allergic rhinoconjunctivitis in children finding family history of atopic diseases and gender to be of importance. The aim of this study was to investigate possible risk factors in early life for rhinoconjunctivitis, allergic as well as non-allergic, in adolescence.MethodsThe children in the Danish Allergy Research Center cohort were examined eight times from birth to 14 years of age. Visits included questionnaire-based interview, clinical examination, skin prick test and specific IgE. We used univariate and multivariate logistic regression to investigate the relationship between early-life risk factors and the development of rhinoconjunctivitis, allergic as well as non-allergic, in adolescence.ResultsFollow-up rate at 14-years was 66.2%. The prevalence of rhinoconjunctivitis was 32.8%. Family history of atopic diseases (aOR 2.25), atopic dermatitis (aOR 3.24), food allergy (aOR 3.89), early sensitization to inhalant and food allergens (aOR 2.92 and aOR 3.13) and male gender (aOR 1.90) were associated with allergic rhinoconjunctivitis but not with non-allergic rhinoconjunctivitis. Early environmental tobacco exposure was inversely associated with rhinoconjunctivitis (aOR 0.42), allergic (aOR 0.47) as well as non-allergic (aOR 0.43).ConclusionDifferent patterns of associations were revealed when stratifying rhinoconjunctivitis in allergic and non-allergic suggesting that allergic rhinoconjunctivitis and non-allergic-rhinoconjunctivitis are different phenotypes.

Severity of Allergic Rhinitis and Body Mass Index: Is There Any Correlation?

Background : Allergic rhinitis is the inflammation of the nasal mucosa. It will be resulting in nasal itching, sneezing, discharge, or blockage which occurs for more than an hour on most days. Allergens such as plant pollens, fungi, animal allergens, and dust mites are the factors which initiate allergic rhinitis. There are many risk factors for allergic rhinitis, such as family history of atopic disease, asthma, age, gender and others. Besides, overweight is also considered one of the risk factors for developing allergic rhinitis. Thus, this study was conducted to investigate the correlation between allergic rhinitis and body mass index. Methods : This study involved a cross-sectional analytic study. Seventy three respondents both male and female medical students of Universitas Padjadjaran completed a questionnaire, and had their height and weight measured by a trained researcher. This study was carried out from September to October 2015. Statistical analyses were performed included the Rank Spearman test. Results : There was no significant relationship between allergic rhinitis and body mass index. Conclusions : There is no correlation between severity of allergic rhinitis and body mass index. [AMJ.2017;4(1):20–4] D OI: 10.15850/amj.v4n1.1018

Association between cord blood IgE levels in newborns and family history of atopic diseases

Background Cord blood-IgE (CB-IgE) levels have been usedwidely as a specific marker of atopic diseases. In some previousstudies, CB-IgE levels in subjects with and without a family historyof atopic diseases have been controversial.Objective To determine the CB-IgE level in newborns and to iden-tify the association between CB-IgE and family history of atopicdiseases.Methods A cross-sectional study was done to compare the CB-IgElevels in neonates with or without a family history of atopic diseasesin mother, father, or siblings. Subjects of this study were 124 new-borns who consecutively born in Puskesmas Kiaracondong,Bandung, during the period of March 2001 to July 2002. Subjectswere divided into 2 groups based on history of atopic diseases.Measurements of CB-IgE levels were done by sandwich ELISAmethods. Data were analyzed by c 2 statistics, t test, ANOVA, andDunkan’s test.Results The mean CB-IgE levels in the group with and without afamily history of atopic diseases were 3.2±2.5 IU/ml and 0.5±0.5IU/ml (P<0.001), respectively. The mean CB-IgE levels in maleand female infants with a family history of atopic diseases were3.3±2.7 IU/ml and 3.03±2.2 IU/ml (P>0.05), respectively. Basedon the cut-off point (1.3 IU/ml), CB-IgE levels had significant posi-tive association with a family history of atopic diseases (OR 156,95%CI 29.61;1104.24). CB-IgE levels in neonates with 1, 2, and 3atopic family members were 1.67±0.78 IU/ml, 3.76±2.11 IU/ml, and6.6±2.7 IU/ml, respectively (F=32.603; P<0.001).Conclusion Most newborns with a family history of atopic dis-eases showed high levels of CB-IgE, but there were no correlationwith gender. The probability of having atopic diseases increase inconcord with the number of family with atopic diseases

Association between immunization coverage and atopy in children with or without family history of atopic disease

Background Atopic diseases are determined by the interactionbetween genetic and environmental factors. The possible effectsof immunization, as one of environmental factors, on atopy remaina matter of controversy.Objective We conducted an observational clinical epidemiologyto find out the protective effect of high vaccination coverage toatopy in children.Methods During January through March 2006, 150 of749 childrenat Garuda, Padasuka, and Babakan Sari Primary Health Care inBandung were randomized from group with and without familyhistory of atopic disease. Atopy derived from skin prick test andtotal serum lgE was evaluated. Atopy was defined as a positiveskin test to any of the eight allergens tested. The immunizationswere recorded from Kartu Menuju Sehat (KMS). Statistical analysesincluded Chi square to compare prevalence, independent T-testand Mann-Whitney to compare mean.Results Atopy was found in 28.2% of284 subjects, of which 32.4%with and 23.9% without a family history of atopic disease. Themedian of total serum lgE level was higher in children with familyhistory of atopic disease and in atopy children. Children weregrouped according to total dose of basic immunizations (0-17 and2: 18) based on Program Pengembangan Imunisasi (PPI). There wasnonsignificant association between total doses of immunizationand atopy. Even though no statistically significant, the cumulativeimmunization doses were inversely related to the median of totalserum IgE level.Conclusions The immunization coverage has not decreased atopyrisk.

Prevalence of oral allergy syndrome in children with allergic diseases

IntroductionThe oral allergy syndrome (OAS) is a particular type of food allergy rarely explored in the paediatric population that is already considered an adult problem. ObjectiveIdentify the prevalence of OAS, symptoms and pollen species associated with its presence in children affected by allergic diseases. MethodsA cross-sectional study was conducted. Consecutive sampling included children from 6 to 14 years who needed allergy treatment for the first time. A structured questionnaire was carried out to collect demographic and clinical data and history of OAS. Besides sensitisation to various allergens, the skin prick-by-prick test was performed to corroborate sensitisation to food related to OAS. Prevalence of OAS and its association with pollens was established following the covariate adjusted logistic regression. Results267 subjects were included. Overall prevalence of OAS was 8.9% (95%CI 6.1–13.1%). Prevalence of OAS for allergic rhinitis and asthma were 8.8% and 9.1%, respectively. In patients sensitised to pollen, the prevalence ranged from 9.6% to 12.2% depending on the type of pollen. 62.5% of children with OAS were sensitive to pineapple. After adjusting for gender and family history of atopic disease, trees from the Quercus species showed an association with OAS (OR=2.7, 95%CI 1.2–6.2). ConclusionsOAS is not uncommon in our environment. Pineapple, a typical fruit from the region, was the main food related. Quercus sp., but not birch nor olive, was the pollen associated with this syndrome.

Clinical Features of Adult/Adolescent Atopic Dermatitis and Chinese Criteria for Atopic Dermatitis.

Background:Atopic dermatitis (AD) is an inflammatory skin disease characterized by chronic recurrent dermatitis with profound itching. Most patients have personal and/or family history of atopic diseases. Several criteria have been proposed for the diagnosis of AD. Although the clinical features of childhood AD have been widely studied, there has been less large-scale study on adult/adolescent AD. The aim of this study was to investigate the clinical features of adult/adolescent patients with chronic symmetrical eczema/AD and to propose Chinese diagnostic criteria for adult/adolescent AD.Methods:A hospital-based study was performed. Forty-two dermatological centers participated in this study. Adult and adolescent patients (12 years and over) with chronic symmetrical eczema or AD were included in this study. Questionnaires were completed by both patients and investigators. The valid questionnaires were analyzed using EpiData 3.1 and SPSS 17.0 software.Results:A total of 2662 valid questionnaires were collected (1369 male and 1293 female). Of all 2662 patients, 2062 (77.5%) patients had the disease after 12 years old, while only 600 (22.5%) patients had the disease before 12 years old, suggesting late-onset eczema/AD is common. Two thousand one hundred and thirty-nine (80.4%) patients had the disease for more than 6 months. One thousand one hundred and forty-four (43.0%) patients had a personal and/or family history of atopic diseases. One thousand five hundred and forty-eight (58.2%) patients had an elevated total serum IgE and/or eosinophilia and/or positive allergen-specific IgE. Based on these clinical and laboratory features, we proposed Chinese criteria for adult/adolescent AD. Of all 2662 patients, 60.3% were satisfied with our criteria, while only 48.2% satisfied with Hanifin Rajka criteria and 32.7% satisfied with Williams criteria, suggesting a good sensitivity of our criteria in adult/adolescent AD patients.Conclusion:Late-onset of eczema or AD is common. The clinical manifestations of AD are heterogeneous. We have proposed Chinese diagnostic criteria for adolescent and adult AD, which are simple and sensitive for diagnosis of adult/adolescent AD.

Prevalence of and risk factors for atopic dermatitis: A birth cohort study of infants in southeast Turkey

BackgroundAtopic dermatitis (AD) is most common in the first year of life. The aim of this study was to determine the prevalence of and risk factors for AD in a birth cohort of infants from southeast Turkey. MethodsAdana Paediatric Allergy Research (ADAPAR) birth cohort study was derived from 1377 infants who were born in Cukurova University, Medical Hospital, Adana, Turkey between February 2010 and February 2011. At birth, a physical examination was performed, cord blood samples were taken, and the mother completed a baseline questionnaire that provided data on gestational conditions, family history of allergic diseases and environmental exposures. Follow-up visits scheduled at 3, 6, and 12 months included an infant physical examination and an extended questionnaire. Skin prick test was performed and food-specific IgE levels were measured at 6 and 12 months. Atopic dermatitis was diagnosed based on confirmatory examination by a physician. ResultsOf the 1377 infants enrolled, 59 (4.3%) were diagnosed with AD as of 12 months. Maternal allergic disease (ORs 6.28, 95% CI 1.03–38.30; p=0.046), maternal infection during gestation (ORs 3.73, 95% CI 1.25–11.09; p=0.018), and presence of food allergy (ORs 13.7, 95% CI 3.07–61.0; p=0.001) were identified as risk factors for AD. Breastfeeding and cord blood IgE levels were not identified as risk factors. ConclusionsIn this cohort we found prevalence of AD as 4.3% during the first year of life. Positive family history of atopic diseases, prenatal infections and presence of food allergy are the risk factors for early presentation of AD.

영유아 아토피피부염 환자 69명의 한의학적 치료효과에 대한 후향적 연구

Abstract Retrospective Study about the Effectiveness of a Korean Medicine Treatment on 69Infant and Young Child Atopic Dermatitis Patients Min Deul Le․Han Myeong Hwa․Park Gun․Seo San․Han Su RyunFreehug Oriental Medicine ClinicObjectivesThe purpose of this study is to report the effectiveness of Korean medicine treatment on 69 infant and young child atopic dermatitis patients.Methods 69 infants and young child atopic dermatitis patients who had visited oriental medical clinics from 2011.1.9 to 2012.1.31 were studied. All of them were continually treated for 3 to 9 months, and were analyzed by Objective SCORAD Index (OSI). A detailed analysis of OSI was done according to gender, age, using of topical steroid ointment, family history of atopic disease, treatment period, and intensity.Results1. Male and female percentage of the study group was 56.5%: 43.5%. The average period of treatment was 6.09 months. 71.0% used topical steroid ointment, and 65.2% had family history of atopic disease.2. The average period of treatment was significantly longer in patients who used topical steroid ointment, or who had family history of atopic disease. 3. 95.7% of total patients reported decrease in OSI score at the final visit. OSI was significantly lowered after 3, 6, and 9 months of treatment. The longer period of treatment, the lower average post-treatment OSI.4. 85.5% of the study group had severe dermatitis, and 14.5% was moderate case based on the OSI intensity assessment at initial visit. These percentages got changed at the final visit as 34.8% of severe, 58.0% of moderate, and 7.2% of mild cases. The average treatment period of patients who were diagnosed as severe at the initial visit was 6.18 months, and their final OSI improvement rate was 39.58%. 58% of them were improved to be mild or moderate at the final visit.ConclusionThe Korean medicine treatment is effective in treating infant and young child atopic dermatitis patients. There was significant decrease in OSI score after 3, 6, and 9 months of treatment. The difference increase with the treatment period.Key words : Atopic dermatitis, Infant and young child, Korean medicine treatment, Objective SCORAD Index (OSI)

Estrés psicológico y la calidad de vida en pacientes con asma bronquial persistente en Manzanillo, Cuba

Psychological stress is part of people's lives and can sometimes contribute to exacerbation of allergic diseases such as asthma. Asthma is prevalent in all age groups. Acute asthma attacks can be triggered by stress, thus impacting control of the disease and overall quality of life in these patients. The purpose of this study is to evaluate the presence of psychological stress as a trigger in poorly controlled asthma patients and its implications in their quality of life. A descriptive study was conducted in the city of Manzanillo, Cuba, in the course of one year, from January to December, 2010, which included 33 patients with persistent asthma. They were grouped according to severity as suffering from moderate or severe asthma, and all of them met the criteria for poorly controlled disease. They were surveyed to gather data about family and personal history of atopy, age of first asthma crisis, and environmental as well as other factors. Two surveys were used: a list of indicators of vulnerability to stress and the Asthma Quality of Life Questionnaire (AQLQ). Most patients with poorly controlled asthma were in their forties. Female patients were more frequently affected than men were (28 females or 84.8%, and 5 males or 15.1%), and most patients had a family history of atopic disease. Almost all patients had high vulnerability to stress as well as low overall quality of life in all the areas surveyed. Psychological counseling is advised for asthma patients in order to reduce their stress levels.

A new index to identify risk of multi-trigger wheezing in infants with first episode of wheezing

Objective: Identification of young children who are likely to have multi-trigger wheezing is very important for early diagnosis and treatment of asthma. We investigate an index for predicting multi-trigger wheezing in infants with first episode of wheezing. Methods: One-hundred twenty-eight infants (2–20 months) with first episode of wheezing were followed for two years. Personal and family history of atopic diseases was recorded. Wheezing severity was evaluated using the Preschool Respiratory Assessment Measure. Sputum samples were collected from patients, stained with hematoxylin and eosin and studied by optical microscopy. The largest Creola body in sputum was located and the number of shed exfoliated airway epithelial cells (EAECs) counted. Recurrent wheezing was observed and classified as multi-trigger wheezing or non-multi-trigger wheezing. The predictive value of EAECs, family or personal history of atopic disease and the severity of wheezing for subsequent development of multi-trigger wheezing was analyzed. Results: Better predictive performance was achieved by considering the three measures together than by considering each separately. Receiver operator characteristic analysis showed that an index combining wheezing severity score of 9495 sputum EAECs and a family or personal history of atopic disease had a sensitivity of 95.1%, specificity of 74.2%, a positive predictive value of 58.6% and a negative predictive value of 93.6% for prediction of multi-trigger wheezing. Conclusion: For infants with first episode of wheezing, wheezing severity score, family or personal history of atopic disease and number of EAECs in sputum can predict future multi-trigger wheezing.

Perinatal factors and the risk of atopic dermatitis: A cohort study

To analyze the effects of pregnancy and early events in the newborn on the risk of subsequent atopic dermatitis (AD) during the first year of life. This is a prospective multicenter cohort study of newborns during the first year of life. Newborns identified on random days in three obstetrics departments in the area of Bergamo, Lombardy, Northern Italy, were eligible. At baseline, the mothers were interviewed by medical staff during their stay in hospital after delivery. At 6 and 12 months after delivery, a postal questionnaire was sent to the parents. Relative risks were calculated with and without adjustment by multiple regression analysis. A total of 1081 newborns entered the study: 796 (74%) parents answered the 12-month questionnaire. Hundred and thirty-eight (17%) reported a diagnosis of AD at 6 months and 222 (28%) at 12 months. Parental history of AD and/or asthma was associated with an increased risk of AD (RR 1.5, 95%CI 1.1-2.0). Birth weight was slightly associated with an increased risk of AD: RR 1.04, 95%CI 1.001-1.08 (continuous variable, increment of 100 grams). No association emerged between breast feeding, smoking, and risk of AD. This study in an Italian offspring cohort points to family history of atopic diseases and body weight at birth as relevant risk factors. The study was unable to document associations with other perinatal factors particularly breast feeding and parental smoking in the perinatal period.

Racemic Adrenaline and Inhalation Strategies in Acute Bronchiolitis: Skjerven HO, Gjengsto Hunderi JO, Brugmann-Pieper SK, et al. N Engl J Med 2013;368:2286–93.

Acute bronchiolitis in infants frequently leads to hospitalization. Despite the burden of this disease, there is no established consensus on inhalation therapy. This multicenter, randomized, double-blind clinical trial compared inhaled racemic epinephrine with inhaled saline, and on-demand inhalation with fixed-schedule inhalation in infants (< 12 months) with moderate-to-severe acute bronchiolitis. The primary outcome was the length of hospital stay, and secondary outcomes included change in clinical score 30 min after the first inhalation, use of nasogastric tube feeding, oxygen supplementation, and ventilator support. Four hundred four (59.4% male) children with a mean age of 4.2 months were enrolled, on hospital admission, from eight hospitals in Norway from January 2010 to May 2011. Inclusion criteria were clinical signs of bronchiolitis, age < 12 months, and a clinical score of at least 4 on a scale of 0–10. Clinical score was calculated by a pediatrician, composed of the sum of points allotted from 0 (normal) to 2 (severe illness) for the following clinical variables: general condition, skin color, auscultatory findings, respiratory rate, and retractions. Exclusion criteria were presence of serious cardiac, immunologic, neurologic, oncologic, or preceding pulmonary disease; more than one prior episode of obstructive airway disease; coughing for more than 4 weeks; and glucocorticoid therapy in the preceding 4 weeks. Subjects were randomized to receive either inhaled epinephrine or inhaled normal (0.9%) saline on either a fixed (not described) or on-demand treatment schedule, resulting in a total of four study groups. There was no significant difference in any of the primary or secondary outcomes in infants treated with inhaled racemic epinephrine vs. inhaled saline (p > 0.1 for all comparisons). Additionally, history of atopic eczema or wheezing, family history of atopic disease, and sex had no significant influence on treatment response. On-demand inhalation was associated with a significantly shorter estimated length of stay – 47.6 h (95% confidence interval [CI] 30.6–64.6) vs. 61.3 h (95% CI 45.4–77.2, p = 0.01) – as well as less use of oxygen supplementation, less use of ventilator support, and fewer inhalation treatments (12.0 vs. 17.0, p < 0.001) when compared to fixed-schedule treatments. The study medication was discontinued in 83 children (20.5%), however, there was no significant difference in discontinuation rate between subjects in the various groups. In infants with acute bronchiolitis, treatment with inhalation of racemic epinephrine was not associated with shorter hospital stay when compared to treatment with inhaled saline. However, inhalation treatments (regardless of agent) given on demand were superior to those on a fixed schedule, with a reduction of mean length of stay of 13.7 h. On-demand treatment was also associated with a mean five fewer total treatments when compared to fixed scheduling, supporting the goal of “minimal handling,” allowing acutely ill infants to sleep with minimal interruption.

Breastfeeding and introduction of complementary foods during infancy in relation to the risk of asthma and atopic diseases up to 10 years

It has been hypothesized that changes in diet during early life may have contributed to the increase in childhood asthma and atopy. The long-term effect of the timing and content of infant feeding on the incidence of asthma and atopic diseases in children is unclear. To investigate the associations between duration of breastfeeding and the timing of introduction of complementary foods during the first 6months and parental-reported asthma, wheeze and atopic eczema up to 10years of age. Infant feeding practices (breastfeeding and introduction of complementary foods) of 1924 singleton children participating in the Study of Eczema and Asthma To Observe the influence of Nutrition (SEATON) birth cohort were prospectively collected up to 6months with outcomes (wheeze, atopic eczema and asthma) being assessed at 1, 2, 5 and 10years. Data were analysed using generalized estimating equations and discrete hazards models with adjustment for confounders. By 6months, 59% and 35% of mothers had stopped exclusive and total breastfeeding, respectively. Although formula feeding was adversely associated with wheeze in the past 12months (adjusted OR for no formula feeding: 070, 95% CI 0.50-0.97), and the introduction of biscuits/bread after 5months of age adversely associated with atopic eczema (adjusted OR 1.34, 95% CI 1.06-1.69), these results lost their statistical significance after adjustment for multiple testing. Stratification of the results by the presence of eczema by 6months of age and family atopic history did not substantially differ from the results of the whole study population. Our results suggest that the nature of infant feeding during the first 6months seems not to substantially influence the long-term risk of asthma and atopic diseases in children, nor in children at high risk of atopic disease because of a family history of atopic disease.

Analysis of the Prevalence of and Risk Factors for Atopic Dermatitis Using an ISAAC Questionnaire in 8,750 Korean Children

Background: Since 1995, epidemiologic studies of atopic disorders using the International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire have been performed in many countries, including the Republic of Korea. The prevalence, burden and risk factors of atopic dermatitis were surveyed in these studies, which helped to enhance their comparability among different areas and age groups, as well as to clarify the nature of atopic dermatitis and other atopic disorders. Methods: From 21 facilities, 8,750 children were enrolled in this cross-sectional study. The data were collected via the Internet using a questionnaire based on the Korean-language version of the ISAAC study format. Results: The prevalence of atopic dermatitis over the previous 12 months was 14.4%. The prevalence in preschool children was significantly higher than in elementary school children. Family history of atopic diseases, diagnosis of allergic conjunctivitis and diagnosis of food allergy were positively associated with atopic dermatitis in both preschool and elementary school children. In addition, raising pets was positively associated with atopic dermatitis in preschool children. In elementary school children, female gender, secondhand smoking, breastfeeding, changing the parents' house to a newly built one during the first year of life, diagnosis of asthma and diagnosis of allergic rhinitis were positively associated with atopic dermatitis. Conclusion: The prevalence of atopic dermatitis in preschool and elementary school children in Korea is similar to that of children in other developing countries. The risk factors for atopic dermatitis are different in preschool and elementary school children. More detailed strategies will be necessary to reduce atopic dermatitis in both age groups.

Bronchial hyperresponsiveness and asthma in the paediatric population

ObjectiveTo determine whether the intensity of bronchial hyperresponsiveness (BHR) is correlated to other clinical data such as patient age at the onset of asthma, the serum IgE levels and familial genetic susceptibility, with the purpose of establishing a prognosis or phenotype. Material and methodsBHR was evaluated using the methacholine provocation test, with the patients divided into six groups according to the amount of methacholine needed to obtain PD20. A total of 138 children and adolescents up to age 18 years (94 males and 44 females) were included. Most had a clinical diagnosis of asthma, while tracheobronchitis or rhinitis was diagnosed among the least reactive subjects. The patients were divided into subjects with a family history of atopic disease (84 cases) and those without such a history (54 cases). In this latter case we discuss possible causes of BHR or dyspnoea triggering factors. ResultsThere were no significant differences in patient age at onset or in serum IgE among the patients with different intensities of BHR, or between those with a family history of atopic disease and those without. ConclusionsNo differences were found among the groups. It is therefore concluded that the intensity of BHR is not a valid parameter for establishing a prognosis or phenotype, although it can be used to assess the severity of asthma.

Evaluation of risk factors in wheezy infants

Objectives: In this study, it was aimed to investigate the environmental risk factors and demographic characteristics of wheezy infants. Methods: A total of 118 children aged 6-24 months, investigated in two subgroups as first wheezing and recurrent wheezing infants. Age and sex matched, healthy 60 children were recruited as the control group. Questionnaire was filled by the parents including knowledge about socio-demographic features, history of familial and personal atopy, age at wheezing onset, parental education, smoking and stove heating at home, familial crowding index and child’s immunization status. Results: First wheezing group included 52, recurrent wheezing group included 66 patients. There was no statistically significant difference between study group and the controls in terms of sociodemographic features (p>0.05). Low educational level of mothers and maternal smoking in the study group was found to be significantly higher than controls (p<0.05). Family history of atopic diseases was significantly higher in the study group compared with the control group. Atopic dermatitis was significantly higher in recurrent wheezing subgroup and was significantly higher in the study group compared with the control group. The ratio of non-vaccinated children was significantly higher in the study group (31%) than the controls (6.7%), and was %6.7 in controls. Conclusion: Maternal smoking and educational level, stove heating at home and lack of immunization are preventable environmental risk factors in wheezing infants. Examining risk factors and giving counseling can prevent recurrent hospitalizations and permanent bronchial damage.

Prevalence of allergen sensitization, most important allergens and factors associated with atopy in children.

Knowledge of the profile of allergen sensitization among children is important for planning preventive measures. The objective of this study was to assess the prevalence and profile of sensitization to inhaled allergens and food among children and adolescents in an outpatient population in the city of Palmas. Cross-sectional study at outpatient clinics in Palmas, Tocantins, Brazil. Ninety-four patients aged 1-15 years who were attending two pediatric outpatient clinics were selected between September and November 2008. All of the subjects underwent clinical interviews and skin prick tests. A positive skin prick test was observed in 76.6% of the participants (72.3% for inhalants and 28.9% for food allergens). The most frequent allergens were Dermatophagoides pteronyssinus (34%), cat epithelium (28.7%), dog epithelium (21.3%), Dermatophagoides farinae (19.1%), Blomia tropicalis (18.1%), cow's milk (9.6%) and grasses (9.6%). A positive skin prick test correlated with a history of atopic disease (odds ratio, OR = 5.833; P = 0.002), a family history of atopic disease (OR = 8.400; P < 0.001), maternal asthma (OR = 8.077; P = 0.048), pet exposure (OR = 3.600; P = 0.012) and cesarean delivery (OR = 3.367; P = 0.019). Dermatophagoides pteronyssinus was the most frequent aeroallergen and cow's milk was the most prevalent food allergen. There was a positive correlation between a positive skin prick test and several factors, such as a family history of atopic disease, maternal asthma, pet exposure and cesarean delivery.

아토피 아동 가정내 집먼지 진드기 농도와 환경요인: 환자 대조군 연구

Department of Environmental Health, Graduate School of Public Health, Seoul National University, Seoul, Korea*Environmental Health Center, College of Medicine, University of Ulsan, Ulsan, Korea**Department of Occupational and Environmental Medicine, College of Medicine, University of Ulsan, Ulsan, KoreaABSTRACTObjectives: The purpose of this study was to determine house dust mite concentrations in living rooms andbedding materials in atopic case-control groups. Methods: Fifty four homes with children suffering atopic diseases as cases and fifty one homes without atopicdiseases as controls were selected after diagnosis at three elementary schools in Ulsan City. Dust samples werecollected from the living rooms and bedding materials in each home during summer and winter with a vacuumcleaner and analyzed for house dust mites using enzyme-linked immunosorbent assay (ELISA). Environmentalfactors and family history were surveyed during sampling. Results: Both species of house dust mite Dermatophagoides farina (Der f 1) and Dermatophagoidespteronyssinus (Der p 1) were found in all homes. Derf1 concentrations were much higher than Der P1concentrations, both in atopic homes (1518.9 vs. 27.0 ng/g. dust, respectively) and non-atopic homes (810.8 vs.44.3 ng/g. dust, respectively). Der f 1 concentrations were significantly higher in the atopic group than in thenon-atopic group (atopic: 1518.9 ng/g.dust, non-atopic: 810.8 ng/g.dust, p = 0.035). However, total house dustmite Der p 1 concentrations were significantly higher in the non-atopic group than in the atopic group (atopic:27.0 ng/g.dust, non-atopic: 44.3 ng/g.dust, p = 0.035). Multiple regression implied that mothers with familyhistory of atopic diseases (OR = 4.79, 95% CI = 1.81-12.69), Der f 1 concentrations (OR = 1.74, 95% CI = 1.07-2.81), and air freshener use (OR = 4.60, 95% CI = 1.72-12.34) had significant associations with atopic children. Conclusion: House dust mite Der f 1 concentrations were associated with atopic children. This study suggeststhat parents should reduce house dust mite Der f 1 concentrations through environmental controls. Keywords: case-control, atopic disease, house dust mite, environmental factor, allergen

474 Relationship Between Total Serum IgE, Atopy, and Obesity in Children With or Without Family History of Atopic Disease

BackgroundPrevalence of obesity and atopy had been increased simultanoeuosly. The relationship between obesity, atopy, and total serum IgE had been estimated. The aim of this study is to find out the relationship between total serum Ig E, atopy, and obese children with or without family history of atopic disease.MethodsThis was a cross sectional study. There were 160 children aged 6 to 11 years which were divided into 4 groups: obese children with and without family history of atopic disease and normal weight children with and without family history of atopic disease. Atopic was defined by positive result of one of allergens skin prick test and ECLIA method were done for total serum IgE. Significancy for categorical data used Chi-Square test. Logistic regression model were used to examine the relationship between obesity, total serum IgE, and atopy.ResultsWe measured the total serum IgE of 155 children. The number of obese and normal weight children with family history of atopic disease who had high level of total serum IgE were 30 and 25 respectively, whereas these children who had normal level of total serum IgE were 6 and 15 respectively [OR = 1.9 (95% CI 0.9-3.9)]. On the other hand, obese and normal weight children without family history of atopic disease who had high level of total serum IgE were 21 and 11 respectively, whereas these children who had normal level of total serum IgE were 18 and 29 respectively [OR = 1.7 (95% CI 1.1-2.7)]. The number of obese and normal weight children without family history of atopic disease who had atopy were 38 and 9 respectively, whereas these children who had non-atopy were 2 and 31 respectively [OR = 13.3 (95% CI 3.5-52)], but there was no relationship between atopy and obesity in group with family history of atopic disease (P = 0.314).ConclusionsThere were relationship between high level of total serum IgE and obesity in group with and without family history of atopic disease and also relationship between atopy and obesity in group without family history of atopic disease.